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<br />I <br /> <br />,--:~~ <br /> <br /> <br />I.. .~..nep"Sk' <br />. . depar.tm. - ent- <br />of revenue <br />l.len Serial Number <br /> <br />Notice of State Tax Lien <br /> <br />Nebra'ska:J.O. No, <br /> <br />Den' FUed, With Spouse's Social ,security <br />~l RG!llstar' 0-1 oeed5 Number <br />~ _Co:Jnty-Clerk <br />BUSIIIlESSNAME AND I.DCATION ADDRESS <br /> <br />Lien Type <br />.Kl Original <br />0, J~el1ewal <br />,County <br /> <br />Date <br /> <br />. Read ,instructions' on reverse side <br />Social Secu'rlty,Number <br /> <br />4/08/454 <br /> <br />8~10-84 <br /> <br />Hall <br /> <br />Inc. <br /> <br />Street'_Address <br />1404 South Locusx <br /> <br />City <br />Grand Is.land, <br /> <br />State <br />NE <br /> <br />Zip-Code <br />68801 <br /> <br />Date of Amount of Tax Penalty <br />Assessment <br />ru <br />7-12-83 470.98 36.59 173.08 <br /> 1,621.57~, " 123~.15 <br /> -v- <br /> 945.05 29.23 60.53 <br />01 820.43 25.37 43.43 <br /> <br />I hereby cet"tify that the Nebraska O.partment of Re...enue has cQmplied: <br />rnlnation of the amount shown to be due. and the taxpayer has failed to <br />Lien is &0 extension of an effective lie it s.rves to continue tne priority <br /> <br />sign.' <br />Itere <br /> <br /> <br />Revenue AQent <br /> <br />Title <br /> <br />Cate <br /> <br />Special Aqent <br /> <br />8-10'-84 <br />Date <br /> <br />Title <br /> <br />NEBRASK.A DEPA.RTMENT OF REVENUE - White and GOldenf"od Copies <br /> <br />TAXPAYER - Pmk Copy <br /> <br />COUNTY OFFICE ,- Canery Copy <br /> <br />4.494.74 Rev. 7.81 <br />Super-s-edes 4~49-4~'74 Rev. 5.80_ <br /> <br />u <br /> <br />L <br /> <br />L <br /> <br />-1 <br /> <br />L <br />